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Young Women Need Careful Counselling On Tubal Ligation

Women who undergo tubal ligation before the age of 30 appear to have a high risk of regretting the procedure.

A change in marital status and the desire to have a child with a new partner is the overwhelming reason these women regret tubal ligation and request in vitro ferilisation (IVF), according to researchers from the Midwifery Research Unit, Hornsby Hospital, in Hornsby, New South Wales, Australia.

If changing partners cannot always be anticipated, there are other factors that point to a need for some women considering tubal ligation to receive special cautioning and counselling, the researchers report.

This case control study aimed to identify and describe pre-sterilisation characteristics most consistently linked with intensive later regret and IVF request. Participants included 97 sterilised women who underwent evaluation for IVF between 1986 and 1996 and 101 sterilised women who remained satisfied with their decision to have tubal ligation.

Main outcome measures were variables known at the time of sterilization -- age, number of living children, history of abortion, underlying medical diseases, marital status, race, education and timing of sterilisation.

Multivariate analysis indicated age at the time of sterilisation had the most pronounced impact on strong regret, with women younger than 30 years old at the time of the procedure more likely later to request IVF treatment than those aged 30 years to 34 years at the time.

A concurrent caesarean section was associated with a threefold risk relative to an interval procedure. A strong protective effect was found (OR = 0.07) for women with more than two children compared to childless women.
Aust N Z J Obstet Gynaecol 2002;42(5):526-9. "Risk factors for strong regret and subsequent IVF request after having tubal ligation."

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